Cutaneous erysipeloid metastasis of cholangiocarcinoma and evaluation by in vivo reflectance confocal microscopy

Cutaneous metastases are relatively uncommon, occurring in only 0.7% to 9% of all internal malignancies.1 Cholangiocarcinoma is a rare bile duct neoplasm that accounts for less than 2% of maligancies.2 Although it is well known that cholangiocarcinoma metastasizes to the lungs, liver, peritoneum, and retroperitoneal lymph nodes,2 a retrospective review of the literature from 1978 to 2014 indicates only 30 cases of cutaneous cholangiocarcinoma, with 17 cases presenting without concurrent metastasis in other sites.